This invention relates to equipment, systems and methods for the removal and/or treatment of gaseous and/or substantially gaseous material. Such material includes, but is not limited to aerosol and particle byproducts of surgical procedures and any procedures involving cutting, heating or burning, and may include, for example, chemicals, ultrasonic vapors, particles, and ion dust particles. More particularly, the present invention relates to an evacuation system that efficiently removes smoke, odor, vapor, particles or plumes released by chemicals or produced by the use of lasers, sonic cutting and/or cautery or other surgical techniques or instruments at a surgical site.
Heating and/or burning of tissue during surgical procedures has become commonplace. An unwanted byproduct of such heating and/or burning, however, is the smoke and/or aerosol generated thereby. Smoke plumes can obscure the surgeon's field of vision and the odor generated is unpleasant and distracting to the entire surgical team and to the patient, if awake. Moreover, the smoke plume may contain infectious agents that present a danger to persons in the operating room, and which can leave a lingering contamination within the operating area. Chemical vapor may be irritating to the respiratory tract of those who inhale it and may be carcinogenic.
Smoke evacuation and filtering systems have been developed to remove smoke plumes from surgical sites and/or chemical vapors from a work environment. Such systems typically include a vacuum source or generator, a conduit connected to the vacuum source and a suction wand or end effector connected to the conduit for being placed at or near the site at which the plumes or vapors are generated. Various filtration systems have been used in conjunction with such systems to remove odor and infectious agents. Known evacuation systems are disclosed in U.S. Pat. No. 4,921,492 (Schultz) and U.S. Pat. No. 7,207,977 (Thompson), the disclosures of which patents are incorporated herein by reference. U.S. Pat. No. 5,015,243 (Schifano) discloses another smoke evacuator for drawing smoke and air from around a surgical site as smoke is produced.
In some embodiments, current state of the art devices for removal of smoke and/or other byproducts generated during laparoscopy are devices for passive evacuation and filtration wherein an ULPA-activated charcoal filter is attached to the side vent of a trocar. Flow and filtration rely at least in part on the pressure difference between the interior of the abdomen and outside of the body to generate a flow to remove and filter the smoke. In some embodiments, depending upon the system and/or the method of flow restriction and/or regulation, flow rates of smoke-laden carbon dioxide gas is 6-10 liters per min. from the abdomen, through the filter and into ambient air.
Today's relentless reduction in reimbursement by insurance agencies for hospital invoices make cost-effective methods for surgical procedures imperative. For example, a $25/filter used in one and a half to two million cases/year creates a healthcare expense of $37.5-50M/year.
While known smoke evacuation systems and end effectors, e.g., those of the Schultz, Thompson and Schifano type, are well-suited for their intended purposes, there is room for improvement.